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8/17/2019 THALASSEMIA klp 2.rtf
1/25
KEPERAWATAN ANAK
“THALASSEMIA”
OLEH
KELOMPOK 2
DAVID SATRIA MAULANA 1110321023
PRIMA SANRIA DEWI 1110321025
NOVIA PUTRI NINGSIH 1110321027
IRHAMNA 1110321029
RAFIKA INDAH 1110322001
RAHMAWITA ARMAN 1110322003
LENTRA GEOTIRA SYARA 1110322005
IKHSAN DWI SETYANDI 1110322007
RATIH DERMA KAMSIL 1110322011
WAHYUNI ARIATI SUKMA 1110322013
RAHIMA KHAIRINA 1110322015
FAKULTAS KEPERAWATAN
UNIVERSITAS ANDALAS
2013
1
8/17/2019 THALASSEMIA klp 2.rtf
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BAB I
PENDAHULUAN
A. Latar Belaa!"
Di Indn!"i#$ 10 d#%i 100 %#n& #d#'#( )#%i!% *(#'#""!+i#$ Ini (#"i' %i"!* ,#n&
+!n)!nn&-#n. 20/*# !ndd- Indn!"i# +!+#4# &!n !n,#-i* *#'#"!+i#$ M!%!-#
!%!'#n& +!4#%i"-#n !n,#-i* -!'#in#n d#%#( i* -!#d# -!*%n#nn,#$ T(#'#"!+i# #d#'#(
!n,#-i* ,#n& "i#*n,# di*%n-#n$ P!n,#-i* ini6 +!%#-#n !n,#-i* -!'#in#n !+!n*-#n
"!' d#%#( +!%#($
T(#'#"!+i# +!%#-#n !n,#-i* #n!+i# (!+'i*i- (!%!di*!% ,#n& di*%n-#n "!)#%#
%!"!"i6 +!n%* (-+ +!nd!'$ P#d# *#(n 19256 di#&n"# !n,#-i* ini !%*#+# -#'i
di++-#n '!( T(+#" '!, 8'!,#n!+i#: ,#n& di d##* di#n*#%# -!'#% -!*%n#n
i*#'i# ,#n& !%+-i+ di USA$ K#*# *(#'#""!+i# !%#"#' d#%i #(#"# ,n#ni ,#n& !%#%*i '#*$
S-%inin& *(#'#""!+i# "#'#( "#* )#%#n,#6 "!*i# %#n& #-#n di)#%i *#( ##-#( di#
)#%i!% #*# -#( n%+#'$ K#%!n# ##i'# "!%#n& )#%i!% +!ni-#( d!nn )#%i!% +#-#n,#
-!+n&-in#nn,# 25; #n#- #-#n +!nd!%i*# *(#'#""!+i# d#n -!+n&-in#n ini #-#n *!*#
"#+# #d# "!*i# -!'#(i%#n$
B. R#$#%a! Ma%ala&
1. A# ,#n& di+#-"d d!nn *(#'#""!+i#<
2. A# !n,!# d#n &!#'# d#%i *(#'#""!+i# ini<
3. =#i+#n# #*i"i'&i d#n -+'i-#"i d#%i !n,#-i* *(#'#""!+i#<
4. =#i+#n# #"-! #d# !nd!%i*# *(#'#""!+i#<
C. T#'#a!
1. Un*- +!n&!*#(i d!ini"i *(#'#""!+i#2. Un*- +!n&!*#(i !n,!# d#n &!#'# d#%i *(#'#""!+i#$
3. Un*- +!n&!*#(i 4) d#n -+'i-#"i !n,#-i* *(#'#""!+i# ini$
4. Un*- +!n&!*#(i #"-! #d# #n#- !nd!%i*# *(#'#""!+i#$
BAB II
2
8/17/2019 THALASSEMIA klp 2.rtf
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PEMBAHASAN
A. A!at($) *a! F)%)(l(") Sel Dara& Mera&
#$ P!+!n*--#n H!+&'in
Sin*!"i" (!+&'in di+'#i d#'#+ !%i*%'#"* d#n *!%" !%'#n&"n& "#+#i *in&-#*
n%+'#"* d#n %!*i-'"i*$ D#%i !n,!'idi-#n d!nn i"* di-!*#(i #(4# #&i#n (!+ d#%i
(!+&'in *!%*#+# di"in*!"i" d#%i #"!*#* d#n &'i"in d#n "!#&i#n !"#% "in*!"i" ini *!%#di
d#'#+ +i*-nd%i#$ L#n&-#( #4#' "in*!"i" #d#'#( !+!n*-#n "!n,#4# i%'$ S!'#n*n,#
!+#* "!n,#4# i%' !%"#* +!+!n*- "!n,#4# %*%i%in ,#n& -!+di#n !%i-#*#n
d!nn +!+!n*- +'!-' (!+$ A-(i%n,# !+#* +'!-' (!+ !%i-#*#n d!nn "#*
+'!-' &'in6 "#* &''in ,#n& di"in*!"i" d#'#+ %i"+ %!*i)'+ !nd'#"+#6
+!+!n*- (!+&'in$ H!+&'in +!+n,#i !%#* +'!-' >?$?5@$
I-#*#n (!+&'in d!nn -"i&!n$ G#+#%#n ,#n& #'in& !n*in& d#%i +'!-'
(!+&'in #d#'#( -!+#+#nn,# +!n&i-#* -"i&!n d!nn '!+#( d#n "!)#%# i%%!!%"i!'$
Fn&"i %i+!% (!+&'in d#'#+ *( *!%n*n& #d# -!+#+#nn,# n*- !%i-#*#n
d!nn -"i&!n d#'#+ #%/#% d#n -!+di#n +d#( +!'!#"-#n -"i&!n ini -! -#i'!%
#%inn *!+#* *!-#n#n " -"i&!n #( '!i( %!nd#( d#'#+ #%/#%$ O-"i&!n *id#- !%i-#*#n d!nn !"i !%% ,#n& !%#'!n"i "i*i d# d#'#+ +'!-' (!+&'in$ T!*#i i#
!%i-#*#n '!+#( d!nn "#'#( "#* !n#+ B-%din#"iB d#%i #*+ !"i$ I-#*#n ini "#n* '!+#(
"!(in& i-#*#n ini +d#( "!-#'i %!!%"i'!$8G,*n61995:
Did#'#+ "+"+ *'#n& di#* %*!in$ H!+&'in6 "#* #(#n ,#n& !n*in&
"!-#'i d#'#+ !%i*%"i* di!n*- d#'#+ "+"+ *'#n&$ H!+&'in ini di!n*- d#%i (!+
d#n &'in$ H!+ "!ndi%i *!%di%i d#%i !+#* "*%-*% i%' d!nn #*+ F! di*n(n,#6
"!d#n&-#n &'in *!%di%i d#%i d# #"#n& %#n*#i 'i!*id#$
C!ni" (!+&'in n%+#' ,#n& di*!+-#n #d# +#n"i# i#'#( H A ,#n& -#d#%n,#
-i%#/-i%# 9@ ; d#%i -!"!'%(#n (!+&'in6 H F ,#n& -#d#%n,# *id#- '!i( d#%i 2; #d#
#n#- !%+% '!i( d#%i 1 *#(n d#n H A2 ,#n& -#d#%n,# *id#- '!i( d#%i 3;$ P#d# #,i
#% '#(i% -#d#% H F +#"i( "#n* *in&&i ,#i* -i%#/-i%# 90; d#%i "!'%( (!+&'in #,i
*!%"!*$ P#d# !%-!+#nn "!'#n*n,# -#d#% H F ini #-#n !%-%#n& (in& #d# +% 1
*#(n -#d#%n,# *id#- '!i( d#%i 2;$
R#n*#i 'i!*id# H A *!%di%i d#%i 2 %#n*#i #'# d#n 2 %#n*#i !*#$ H F *!%di%i d#%i 2
%#n*#i #'# d#n 2 %#n*#i ++#$ H A2 *!%di%i d#%i 2 %#n*#i #'# d#n 2 %#n*#i ++#$ O'!(
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-#%!n# i* !ni" (!+&'in *!%"!* di!%i *#nd# " . H A 2 2 H F2 d2 d#n H
A22 d2$ R#n*#i #'# +!+n,#i 1?1 #"#+ #+in "!d#n&-#n %#n*#i !*# d#n ++#
+!+n,#i 1?> #"#+ #+in$ 8I'+ -!"!(#*#n An#-619@5:
$ M!*#'i"+! =!"i
K#%!n# !"i !n*in& #&i !+!n*-#n (!+&'in6 +i&'in d#'#+ **6 d#n #*/#*
ini !%' +!n&!*#(i )#%#/)#%# !"i di&n#-#n d#'#+ *($ C+'#( **#' !"i d#'#+ *(
%#*#/%#*# "!-i*#% ? &%#+6 -i%#/-i%# >5 ; di#n*#%#n,# d#'+ !n*- (!+&'in$ S!-i*#% ?;
*!%d##* d#'#+ !n*- +i&'in6 1; d#'#+ !n*- !%#i "!n,#4# (!+ ,#n& +!n#"i
-"id#"i in*%#"!'6 061; !%i-#*#n d!nn %*!in *%#n"!%in d#'#+ '#"+# d#%#(6 d#n "#+#i
30; *!%*#+# di"i+#n d#'#+ (#*i d#'#+ !n*- !%%i*in$
)$ T%#n"% d#n !n,i+#n#n !"i
=i'# !"i di#"%"i d#%i "" (#'"6 "!&!%# i# !%i-#*#n d!nn &''in6 *%#n"!%in6
d#n di*%#n"% d#'#+ !n* i-#*#n ini did#'#+ '#"+# d#%#($ =!"i !%i-#*#n "#n* '!+#(
d!nn +'!-' &''in d#n #-i#*n,# d##* di'!#"-#n -!"!*i# "!' #%inn d#n #d# "!*i#
*!+#* d#'#+ *($ K!'!i(#n !"i d#'#+ d#%#( di*i+n -(""n,# d#'#+ "!' (#*i6 *!+#*
"!-i*#% >0; !"i ,#n& !%'!i(#n di"i+#n$ Di"ini !"i !%i-#*#n d!nn %*!in #!%%i*in6
n*- +!+!n*- !%%i*in$ A!%%i*in +!+n,#i !%#* +'!-' -i%#/-i%# ?>0 %i d#'#+
!%#i -#n*i*#" !"i6 d#'#+ -!'+--#n %#n*#i !"i d##* !%i-#*#n d!nn +'!-' ,#n&
'!i( !"#%$ O'!( -#%!n# i*6 !%%i*in d##* +!nndn& !"i d#'#+ +'#( "!di-i* #*# d#'#+
+'#( ,#n& %!'#*i !"#%$ =i'# +'#( !"i d#'#+ '#"+# *%n "#n* %!nd#(6 !"i di-!'#%-#n
d#%i !%%i*in d!nn +d#( "!-#'i$ =!"i -!+di#n di*%#n"% -!#&i#n/#&i#n *( ,#n&
+!+!%'-#n$ =i'# "!' d#%#( +!%#( *!'#( +!n)##i +#"# (idn,# d#n di(#n)%-#n6
(!+&'in ,#n& di-!'#%-#n d#%i "!' di)!%n# '!( "!'/"!' %!*i-'!nd*!'$ Di"ini di-!'#%-#n
!"i !#"6 d#n !"i ini -!+di#n d##* di"i+#n d#'#+ #n&-#'#n !%%i*in #*# di#-#i
-!+#'i n*- !+!n*-#n (!+&'in$
d$ A"%"i !"i d#%i "#'%#n !n)!%n##n
=!"i di#"%"i (#+i% "!'%(n,# d#'#+ "" (#'" #&i#n #*#"6*!%*#+# d#'#+
dd!n+$ =!"i di#"%"i d!nn %"!" #"%"i #-*i6 4#'#n +!-#ni"+! #"%"i #-*i
,#n& "!!n#%n,# *id#- di-!*#(i$
!$ P!n*%#n !"i **#' *( d!nn !%#(#n -!)!#*#n #"%"i$
=i'# #d# (#-!-#*n,# "!+# #!%%i*in *( *!'#( +!n#di !n( d!nn !"i6 +#-#
"'i* *%#n"!%%in& d#%#( +!'!#"-#n !"i -!#%inn$ S!#i #-i#*n,#6 *%#n"!%%in& ,#n&
n%+#'n,# (#n,# !n( "!!%*in,# d!nn !"i6 "!-#%#n& (#+i% "!'%(n,# *!%i-#* d!nn
!"i d#n #-#n (#+i% *#- +!n!%i+# !"i #% d#%i "!' +-"# ""$ K!+di#n "!#i
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"*#di+ #-(i% %"!" ini6 !+!n*-#n -!'!i(#n !"i d#'#+ "!' +-"# "!ndi%i +!n!-#n
#"%"i !"i #-*i d#%i '+!n "" d#n #d# 4#-* ,#n& "#+# "!di-i* +!nin&-#*-#n !-"-%!"i
!"i d#%i +-"#$ 8G,*n61995:
B. K(!%e+ +e!,a)t T&ala%%e$)a
1. De-)!)%) T&ala%%e$)a
T(#'#"!+i# -!'+- (!*!%&!n #n!+i# (!+'i*i- (!%!di*!% ,#n& di*#nd#i '!(
!n%n#n -!)!#*#n "in*!"i" "#* %#n*#i 'i!*id# (!+&'in #*# '!i( di-'#"ii-#"i-#n
+!n%* %#n*#i ,#n& *!%-!n# 8#'#6 !*#6 ++#: d# -#*!&%i +#,% #d#'#( #'#/d#n !*#/
*(#'#"!+i#$#'#/*6 *(#'#"!+i# ,#n& di"!#-#n '!( !n%n#n -!)!#*#n "in*!"i" %#n*#i #'#
(!+&'in 8K#+" D%'#n62000 :
T(#'#"!+i# #d#'#( "!-!'+- -!'#in#n d#%#( ,#n& di*(-#n '!( &!n!*i-6 ,#n&
di*#nd#i '!( !%-%#n&n,# %d-"i %#n*#i #'# d#n !*# &'in ,#n& +!+!n*-
(!+&'in$ S!+# !n*- *(#'#"!+i# di*%n-#n "!#i "i#* %!"!"i #*"+$#d#
*(#'#"!+i# 6 %#n*#i +!n+- d#n #-(i%n,# +!n&!nd# d#n +!n,#-#n #n!+i# !%#*
8*(#'#"!+i# +#,% d#n #n!+i# )'! :$ 8 D!%!- L'!4!'',n6 20006 (#' 121 :
T(#'#"!+i# . !n,#-i* #4##n ,#n& di*%n-#n '!( "#'#( "#* %#n&*# -!#d#
#n#-n,# "!#- +#"i( d#'#+ -#ndnn$ Ci-# #"#nn "#+i/i"*%i #d#'#( !+#4# &!n
*(#'#"!+i#6 +#-# -!+n&-in#n #n#-n,# #-#n +!nd!%i*# *(#'#"!+i# "!!"#% 25;6 !+#4#
&!n *(#'#""!+i# 850;: d#n n%+#' 825;:
H!+&'in 8H: +!%#-#n "#* #* di d#'#+ "!' d#%#( +!%#( 8!%i*%"i*: ,#n&
!%n&"i +!nn&-* -"i&!n d#%i #% -! "!'%( #%inn *( d#n +!+!%i 4#%n# +!%#(
#d# !%i*%"i*$ D#'#+ -!#d##n n%+#'6 H *#+# *!%di%id#%i &&" H!+! d#n +!+n,#i 2
%#n*#i #'# 8: d#n *#+# %#n*#i !*# 8:$
C!ni" T(#'#""!+i# .
1. T(#'#""!+i# #'#
T!%#di i-# #d#n,# -!'#in#n "in*!"i" %#n*#i &'in #'# 8:$ Ad# ? +#)#+ *(#'#""!+i#
#'# 8: !%d#"#%-#n #n,#-n,# &!n ,#n& *!%n&&6 ,#i* .
a. D!'!"i 1 &!n 8"i'!n* )#%%i!%":
K!'#in#n H "#n* +ini+#' d#n *id#- +!+!%i-#n &!#'#$ K!#d##n ini (#n,#
d##* di'i(#* d#%i !+!%i-"##n '#%#*%i+ "!)#%# +'!-'!%$
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b. D!'!"i 2 &!n 8*(#'#""!+i# *%#i*:
P#d# *#(# ini d!*!+-#n #d#n,# #n!+i# %inn #*#n *id#- #d# #n!+i#$
c. D!'!"i 3 &!n 8P!n,#-i* HH:
=i"# did!*!-"i "!*!'#( -!'#(i%#n6 di"!%*#i #n!+i# !%#* d#n !+!"#%#n 'i+#$
d. D!'!"i ? &!n 8(,d%" !*#'i":
=i#"#n,# #,i #-#n +!nin&' d#'#+ -#ndnn #*# "!*!'#( di'#(i%-#n -#%!n#
-#d#% H n%+#' *id#- +n&-in *!%!n*-$
2. T(#'#""!+i# !*#
P#'in& #n,#- di+#i di Indn!"i# !%d#"#%-#n #n,#-n,# &!n ,#n& !%+*#"i
di-!n#' *(#'#""!+i# (+i&* i'# *!%d##* +*#"i #d# -!d# &!n d#n *(#'#""!+i#
(!*!%i&* i'# *!%d##* +*#"i #d# 1 &!n !%d#"#%-#n +#%#n -'ini- di-!n#' 3
+#)#+ *(#'#""!+i# ,#i* .
a. T(#'#""!+i# +#,%
T!%#di +*#"i #d# -!d# &!n 6 #"i!n +!+!%'-#n *%#n"i d#%#( "!)#%#
!%-#'#6 *!%d##* !+!"#%#n 'i+# ,#n& +#-in '#+# +#-in !"#% "!(in&
+!+!%'-#n *ind#-#n !nn&-#*#n 'i+# ,#n& di"!* "'!n!-*+i$ S!'#in i*
#"i!n +!n'#+i !n+-#n #* !"i di d#'#+ *( #-i#* *%#n"i -%#n& d#n
!n,!%##n !"i ,#n& !%'!i(#n6 "!(in& di!%'-#n !n&#*#n !n&!'#%#n
#* !"i d#%i *( ,#n& di"!* -!'#"i$
b. T(#'#""!+i# +in%M*#"i *!%#di #d# "#'#( "#* d#%i &!n 6 ini di"!* d!nn -!'#in#n
*(#'#""!+i# *%#i*$ P#d# -!#d##n ini -#d#% H n%+#' #*# #n!+i# %inn d#n
#"i!n *id#- +!nn--#n &!#'# -'ini-$
c. T(#'#""!+i# in*!%+!di# 8 #n*#%# *(#'#""!+i# +#,% d#n +in% :
P#"i!n d!nn *(#'#""!+i# ini +!nn--#n -!'#in#n #n*#%# *(#'#""!+i# +#,%
d#n +in%$ P#"i!n i#"#n,# (id n%+#' *!*#i d#'#+ -!#d##n *!%*!n* "!!%*i
in!-"i !%#* #*# -!(#+i'#n +!+!%'-#n *ind#-#n *%#n"i d#%#($
3. H!+&'in #%i#n
Ad#'#( !n,#-i* ,#n& di"!#-#n '!( !%#(#n #"#+ #+in d#%i %#n*#i &''in$
K!'#in#n #d# ""n#n #"#+ #+in %#n*#i &''in di-!n#' (!+&'in E6
(!+&'in S d#n ++in#"in,# d!nn *(#'#""!+i# $ K!'#in#n ini #n,#-
di+#i di Indn!"i#$
2. Et)(l(") T&ala%%e$)a
T(#'#"!+i# *!%#di -#%!n# -!'#in#n #*# !%#(#n #d# &!n &'in #*# ,#n&+!n*% %d-"i %#n*#i #*# $ =!%-%#n& #*# *id#- *!%!n*- "#+# "!-#'i %#n*#i &'in
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di"!* T(#'#""!+i#$ K!#d##n ini +!n,!#-#n %d-"i (!+&'in *!%n&& d#n +%
!%i*%"i* +!+!nd!-$ D#'#+ -!#d##n n%+#'6 +% !%i*%"i* !%-i"#% 120 (#%i$
T(#'#"!+i# +!%#-#n !n,#-i* #n!+i# (!+'i*i-6 di+#n# *!%#di -!%"#-#n #d# "!'
d#%#( +!%#( di d#'#+ !+'( d#%#( "!(in +% !%i*%"i* !nd!- 8-%#n& d#%i 120 (#%i:$
K!%"#-#n *!%"!* di"!#-#n '!( H= ,#n& *id#- n%+#' "!#i #-i#* d#%i n&&#n
d#'#+ !+!n*-#n %#n*#i &'in #*# "*%-*% H=$ 8A"(#n K!!%#4#*#n =#,i d#n An#-:$
D!!- &!n!*i- ,#n& +!nd#"#%i T(#'#"!+i# +!'i*i d!'!"i **#' #*# #%"i#' &!n %#n*#i
&'in d#n ""*i*"i6 d!'!"i #*# in"!%"i n-'!*id# #-i#* d#%i !%#(#n ini #d#'#(
!n%n#n #*# *id#- #d#n,# +/RNA #&i "#* #*# '!i( %#n*i &'in #*# !+!n*-# +/
RNA ,#n& )#)#* "!)#%# n&"in#' #-i#*n,# #d#'#( !n%n#n #*# "%!"i **#' "in*!"i"
%#n*#i 'i!*id# H= 8I'+ K!"!(#*#n An#-:$
K!*id#-"!i+#nn d#'#+ %#n*#i &'in #'# d#n !*#6 ,#n& di!%'-#n d#'#+
!+!n*-#n H= di"!#-#n '!( "!#( &!n )#)#* ,#n& di*%n-#n "!)#%# %!"!"i d#%i -!d#
%#n& *#$ T(#'#"!+i# *!%+#"- d#'#+ #n!+i# (!+'i*i-6 di+#n# +% !%i*%"i* +!n#di '!i(
!nd!-$ U+% !%i*%"i* #d# ,#n& > +in&& #*# @ +in&&$ =#(-#n d#'#+ -#"" !%#*
+%!%i*%"i* #d# ,#n& (#n,# +#+ !%*#(#n "!'#+# 3 +in&& "##$ C#di *(#'#"!+i# '!*#-
%#n*#i 'i!*id# !%!d# %*#nn,# #*# di*-#% d!nn !ni" #"#+ #+in '#in$
F#-*% &!n!*i- ,#i* !%-#4in#n #n*#%# 2 (!*!%i&* 8)#%i!%: ,#n& +!n&(#"i'-#n
-!*%n#n T(#'#"!+i# 8(+i&*:$
3. Ma!)-e%ta%) Kl)!) T&ala%%e$)a
G!#'# d#%i T(#'#""!+i# .
1. An!+i#
P#d# *(#'#""!+i#6 %d-"i %#n*#i &''in #*# !%-%#n& #*# *id#- #d#6 "!(in&
H ,#n& *!%!n*- "#n* -%#n& d#n +!n,!#-#n #n!+i#$ =!%'!i(n,# %#n*#i
&'in ,#n& *id#- !%#"#nn +!n,!#-#n !%i*%"i* +d#( di!)#(-#n '!( 'i+#$
2. P!+!"#%#n 'i+#
O%n 'i+# !%n&"i n*- +!+!%"i(-#n !%i*%"i* ,#n& %"#- d#n !%!%#n d#'#+
!+!n*-#n !%i*%"i*$ P!+!"#%#n 'i+# #d# *(#'#""!+i# d##* *!%#di #-i#* -!%#
'i+# ,#n& !%'!i(#n$
3. F#")i!" )'!,"
P#d# -!#d##n *(#'#""!+i# ,#n& !%#* d##* *!%#di !%#(#n !n*- 4##( ,#n&
di"!* #")i!" )'!,"$ "+"+ *'#n& ii( +!%#-#n "#'#( "#* *!+#* n*-
+!+%d-"i "!' d#%#( +!%#($ P#d# *(#'#""!+i#6 "+"+ *'#n& ii( +!+%d-"i
7
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"!' d#%#( +!%#( !%'!i(#n6"!(in& %n& "+"+ +!+!"#% ,#n& +!n,!#-#n
!nii"#n *'#n& d#n !nn'#n #d# d#(i$
S!+# !ni" *#'#"!+i# +!+i'i-i &!#'# ,#n& +i%i *!*#i !%#*n,# !%#%i#"i$
S!#i#n !"#% +!n'#+i n&&#n #n!+i# %inn$
a. T(#'#"!+i# +in% 8*#'#"!+i# (!*!%&!n: ++n,# (#n,# +!+i'i-i &!#'# !%#
#n!+i# %inn "#+#i "!d#n& d#n +n&-in !%"i#* #"i+*+#*i- d#n "!%in& *id#-
*!%d!*!-"i$
b. T(#'#"!+i# +#,%6 ++n,# +!n#+#--#n +#ni!"*#"i -'ini" #d# "i# > '#n6
"!*!'#( !!- H 7 +!n&(i'#n&$
1. T#nd# #4#' #d#'#( #4i*#n +!nd#d#-6 #n!+i#6 d!+#+ ,#n& *id#- d##* di!'#"-#n6
)#%# +#-#n ,#n& %-6 !nin&-#*#n == d#n !+!"#%#n 'i+#$
2. T#nd# '#n* #d#'#( (i-"i# -%ni" -!%"#-#n (#*i6 'i+#6 #n*n&6 #n-%!#"6-!'!n#% 'i+(! #-i#* (!+-%+*"i"6 i-*!%" %inn #*# 4#%n# -'i*
+!n&-i'#6 -%#ni#' *!#' d!nn ii +!nn' d#n (idn& d#*#% %!*#%d#"i
!%*+(#n d#n -!*!%'#+#*#n !%-!+#nn "!-"#'$
c. K+'i-#"i #n&-# #n#n& "!#i #-i#* d#%i (!+-%+#*"i" d!nn -!%"#-#n "!'
%!"'*#n ,#n& +!n-i#*-#n .
1. S'!n+!''
2. K+'i-#"i "-!'!*#'6 "!!%*i +!n!#'#n *'#n& -%#ni#'6 !+!"#%#n -!#'#6 *'#n&
4##( +!nn'6 +#'-'"i &i&i6 d#n %!n*#n *!%(#d# %#-*% "n*#n$3. K+'i-#"i #n*n&6 "!!%*i #%i*+#i#6 !%i-#%di*i"6 HF d#n i%"i" "!%#* **
#n*n&$
4. P!n,#-i* -#ndn& !+!d6 *!%+#"- #* !+!d$
5. P!+!"#%#n (!#% d#n !%'#n* +!n#di "i%"i" (!#*i"$
6. P!%#(#n -'i*6 "!!%*i i-%!%" d#n %#&+!n*#"i )-'#* #-i#* d!i"i* #* !"i$
7. R!*#%d#"i !%*+(#n d#n -+'i-#"i !nd-%in$
d. G!#'# '#in #d# !nd!%i*# T(#'#"!+i# #d#'#( #n*n& +d#( !%d!#%/d!#%$ H#' ini
-#%!n# -"i&!n ,#&n di#4#( *!%"!* -%#n&6 +#-# #n*n& #-#n !"#(#
!-!%# '!i( -!%#" "!(in& #n*n& !nd!%i*# #-#n +d#( !%d!#%/d!#%6 '#+#/
-!'#+##n #n*n& #-#n !-!%# '!i( -!%#" "!(in& '!i( )!#* '!'#($ S!(in&
*!%#di '!+#( #n*n&6 'i+# !nd!%i*# i"# +!n#di !"#% -#%!n# !n&(#n)%#n d#%#(
*!%#di di "#n#6 "!'#in i* "+"+ *'#n& !-!%# '!i( -!%#" -#%!n# !%"#(#
+!n&-+!n"#"i -!-%#nn H6 "!(in& *'#n& +!n#di *ii" d#n %#( "!(in&
+d#( %#($ Ci-# ini *!%#di #d# +-# 8*'#n& (idn& +#-# 4##( #-#n !%#(
!n*-6 #*#n& (idn& #-#n (i'#n&J +!'!"#- -! d#'#+ 8 fasise cookey: ini +!%#-#n
"#'#( "#* *#nd# -(#" !nd!%i*# *(#'#"!+i#$
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S!)#%# -'ini" T(#'#"!+i# d##* di#&i d#'#+ !!%## *in&-#*#n "!"#i !%#*n,# &!#'# -'ini".
1. +#,%6 in*!%+!di# d#n +in% #*# *%i* 8!+#4# "i#*:$ =#*#" di#n*#%# *in&-#*#n
*!%"!* "!%in& *id#- !'#"$ An!+i# !%#* +!n#di n,#*# #d# +% 3 > '#n "!*!'#(
'#(i% d#n *id#- d##* (id *#n# di*%#n""i$
2. P!+!"#%#n (#*i d#n 'i+# *!%#di -#%!n# !n&(#n)%#n "!' d#%#( +!%#( !%'!i(#n6
(#!+!"i" !-"*%# +d'#% d#n -!'!i(#n !#n !"i$ Li+# ,#n& +!+!"#%
+!nin&-#*-#n -!*(#n d#%#( d!nn +!n#+#( !n&(#n)%#n "!' d#%#( +!%#( d#n
!+"#*#n 8'in&: d#n d!nn +!n,!#-#n !%*#+#(#n '+! '#"+#$
3. P!%#(#n #d# *'#n& -#%!n# (i!%#-*ii*#" "+"+ +!%#( !%# d!%+i*#" d#n
%#-*% "n*#n6 *!%*#+# -#"" ,#n& *id#- #*# -%#n& +!nd##* *%#n""i d#%#($
D!%+i*#" *'#n&6 di"#+in& +!n-i#*-#n +-# +n&'id6 d##* +!n,!#-#n
!%*+(#n !%'!i(#n *'#n& %n*#' d#n i&+#*in "!%*# +#-"i'#$ P!%*+(#n
&i&i i#"#n,# %-$
4. G!#'# '#in ,#n& *#+#- i#'#( #n#- '!+#(6 )#*6 !%-!+#n i"i- *id#- "!"#i
+%6 !%#* #d#n -%#n&6 !%* +!+n)i*$ Ci-# #"i!n *id#- "!%in& +!nd##*
*%#n""i d#%#( -'i* +!n#di -!'# "!%# d!nn !"i #-i#* !ni+n#n !"i
d#'#+ #%inn -'i*$
5. K!#d##n -'ini"n,# '!i( #i- d#n &!#'# '!i( %inn d#%i #d# T(#'#"!+i# +#,%6
#n!+i# "!d#n& 8(!+&'in 7 1060 &Jd':$ G!#'# d!%+i*#" *'#n&6 (!#*+!'i
d#n "'!n+!'i6 !%i*%!"i" !-"*%# +!d'#% d#n +#%#n -!'!i(#n !#n !"i
n#+#- #d# +#"# d!4#"#$6. U++n,# *id#- di+#i &!#'# -'ini" ,#n& -(#"6 di*#nd#i '!( #n!+i# +i-%"i*in6
!n*- (!*!%i&* *!*#i *#n# #n!+i# #*# #n!+i# %inn$
• T(#'#"!+i# +#,% 8T(#'#"!+i# (+i&*:
• T(#'#"!+i# in*!%+!di#
• T(#'#"!+i# +in% #*# *%i* 8 !+#4# "i#*:
7. P#d# (#"#n d#%#( *i di d##*-#n +#%#n (i-%+ +i-%"i*i-6 #ni""i*"i"6
'-'i'"i*"i" d#n #d#n,# "!' *#%&!* 8%#&+!n*#"i d#n #n,#- "!' n%+'#":$
8. K#d#% !"i d#'#+ "!%+ 8SI: +!nin&&i d#n d#,# i-#* "!%+ *!%(#d# !"i 8I=:+!n#di %!nd#( d#n d##* +!n)##i n'$
9. E'!-*%%!"i" (!+&'in +!+!%'i(#*-#n *in&&in,# HF '!i( d#%i 30;6 -#d#n&
di*!+-#n (!+&'in #*'&i-$ Di Indn!"i# -i%#/-i%# ?5; #"i!n T(#'#"!+i#
+!+n,#i HE +#n HS$
10. K#d#% i'i%in d#'#+ "!%+ +!nin&-#*6 SGOT d#n SGPT d##* +!nin&-#* -#%!n#
-!%"#-#n #%#n-i+ (#*i '!( (!+"id!%"i"$
11. P!n,!'idi-#n "in*!"i" #'#J!*# *!%(#d# %!i-'"i* "i%-'#"i +!+!%'i(#*-#n
!nin&-#*#n n,#*# %#*i #'#J!*# ,#-ni !%-%#n&n,# #*# *id#- #d#n,# "in*!*i" %#n*#i
!*#$
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4. Pe$er)%aa! La.(rat(r)#$ *a! D)a"!(%t)
Ad# !!%## ,#n& d##* di'i(#* d#%i d#%#( !nd!%i*# T(#'#""!+i# .
1. HP' #-#n +!n,#*#-#n +i-%"i*"i"6 (i-%+i#6 #+""i*"i"6 'i-("i*"i"6 "!' *#%&!*6
d#n !%)#- #"i'6 ni'#i H= d#n (!+#*-%i* +!n%n$
2. Hi*n& %!*i-'"i #-#n +!n%n
3. E'!-*%%!"i" H #-#n +!n,#*#-#n !nin&-#*#n ni'#i H= F d#n H=A$
4. VS #*# #n#'i"# d#%#( #*# "!' #nin #-#n +!n,#%in& *(#'#"!+i# "##* %#n#*#'
#$ T(#'#"!+i# M#,%
D#%#( *!i did##*-#n +#%#n (i-%+ +i-%"ii-6 #ni""i*"i"6 'i-i' "i*"i"
d#n #d#n,# "!' *#%&!*6 +'#( %!*i-'"i* +!nin&-#* "!%*# #d#n,# "!' "!%i !%i*%"i*6 +d#
8n%+'#"*: H= %!nd#(6 %!"i"*!n"i "+*i- #*'&i"6 ni'#i M6 MV6 MFI6 d#n MH
+!n%n6 +'#( '!-"i* n%+#'J+!ni&n-#*6 -#d#% F! d#'#+ "!%+ +!nin&-#*6 i'i%in6
SGOT d#n SGPT +!nin&-#* -#%!n# -!%"#-#n #%!n-i+ (#*i '!( (!+'i"i"$
$ T(#'#"!+i# Min%
K#d#% H= i#%%#"i$ G#+#%#n d#%#( *!i d##* +!n,!%#i *(#'#"!+i# +#,% J (#n,#
"!-!d#% ni'#i M d#n MH i#"#n,# +!n%n6 "!d#n&-#n MH i#"#n,# n%+#'6
%!"i"*!n"i "+*i- +!nin&-#*$
)$ P!+!%i-"##n '!i( +# #d#'#( #n#'i"# DNA6
DNA d%in&6 &!n!'**in&6 d#n !+!%i-"##n PR 8 Poly merase Chain Reaction:$
d$ G#+#%#n %#di'&i"6
T'#n& #-#n +!+!%'i(#*-#n +!d'#n,#$ Ti"i d#n *%#!-'# -#"#%$ T'#n& *!n&-%#-
+!+!%'i(#*-#n di'! d#n #d# #n#- "i# !%+#in -#d#n&/-#d#n& *!%'i(#* %)( #!%#n)!
8+!n,!%#i %#+* !%di%i *nn !nd!-:$ F%#-*% -+%!"i !%*!%# d##* *!%#di$
T'#n& i +!'!#%6 *!%*#+# #d# #&i#n #%*i-'#"i d!nn %"!"i" *%#n"!%""$
P!+!%i-"##n Di#&n"*i- ,#n& '#in.
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o D#%#( *!i . -#d#% H %!nd#(6 %!*i-'"i* *in&&i6 +'#( *%+"i* d#'#+ #*#" n%+#'
o H#"#n d#%#( *!i . (i-%+ +i-%"i*!%6#ni"'-i'"i*"i"6 'i-%+#"i# "!' *#%&!*6
n%+'#"$%!&+!n*"i*
o Fn&"i "+ "+ *'#n& . (,!%'#"i# n%+'#"*i-
o K#d#% !"i "!%+ +!nin&-#*
o =i'i%in indi%!)* +!nin&-#*
o K#d#% H F! +!nin&-#* #d# *(#'#""!+i# +#,%
o K#d#% H A2 +!nin&-#* #d# *(#'#""!+i# +in%$
o G#+#%#n %#di'&i" *'#n& #-#n +!+!%'i(#*-#n +!d'# ,#n& '#%6 -%*!-" *ii"
d#n *%#!-'# -#"#%$
o T'#n& *!n&-%#- +!+!%'i(#*-#n (#i%/n/!nd ,#n& di"!#-#n !%'#"#n "+"+
*'#n& -! d#'#+ *'#n& -%*!-"$
o T%#n""i d#%#( !%# "!' d#%#( +!%#( 8SDM: "#+#i -#d#% H 11 &Jd'$ C+'#(
SDM ,#n& di!%i-#n "!#i-n,# 10 20 +'J-& ==$
o A"#+ '#* *!%#*% 8+i"#'n,# 5 +& !%(#%i:6 i-# dii* %-
o P!+!%i#n )(!'!*in& #&!n*" 8d!"!%#': "!)#%# *!%#*% +!+!n*- +!n&%#n&i
(!+"id!%"i"$ O#* di!%i-#n "!)#%# in*%#!n# #*# "-*#n6 d!nn #n*#n +#
-!)i'6 2 & d!nn "!*i# ni* d#%#( *%#n""i$
o Vi*#+in 6 200 +& "!*i#6 +!nin&-#*#n !-"-%!"i !"i di(#"i'-#n '!( D!"!%i-"#+in$
o S'!n!-*+i +n&-in di*(-#n n*- +!n%n-#n -!*(#n d#%#($ Ini di*nd#
"#+#i #"i!n !%+% di #*#" > *#(n -#%!n# %!"i- in!-"i$o T!%#i !nd-%in di!%i-#n #i- "!#i !n&n*i #*#n n*- +!%#n&"#n& (ii"!
i-# !%*#" *!%'#+#*$
o P#d# "!di-i* -#"" *%#n"'#n*"i "+"+ *'#n& *!'#( di'#-"#n#-#n #d# +% 1 #*# 2
*#(n d#%i "#d#%# -#ndn& d!nn H'A ))- 8H'A M#*)(!d Si'in&:$ P#d# "##* ini
-!!%(#"i'#n (#n,# +!n)##i 30; -#""$ 8S!#%+#n6 d-- 199> d#n H%#nd6
199>:
5. Pe!atala%a!aa! T&ala%%e$)a
A. P!n#*#'#-"#n##n M!di"
1. T!%#i di!%i-#n "!)#%# *!%#*% n*- +!+!%*#(#n-#n -#d#% H di #*#" 10 &%Jd'$
R&i+!n (i!%*%#n""i ini +!+n,#i -!n*nn -'ini" ,#n& n,#*#6 +!+&-in-#n
#-*ii*#" n%+#' ,#n& n,#+#n6 +!n)!( #* i+ni"#"i d#n +!n)!( !-"#n"i
"+"+ *'#n& d#n +#"#'#( -"+!*i- %&%!"i ,#n& *!%-#i* d!nn !%#(#n *'#n&/
*'#n +-#6 d#n +!+ini+#'-#n di'#*#"i #n*n& d#n !"*!%"i"$ T%#n""i d!nn d"i"
15/20 +'J-& "!' d#%#( +%#( *!%#+#* 8PR: i#"#n,# di!%'-#n "!*i# ?/5 +in&&$
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2. Ui "i'#n& (#%" di-!%#-#n n*- +!n)!( #* i+n"#"i d#n +!n)!( %!#-"i
*%#n""i$
3. M!+ini+#'-#n %!#-"i d!+#+ #-i#* *%#n""i d!nn +!n&&n#-#n !%i*%"i* ,#n&
di%!-n"*%-"i d#%i d#%#( !- #*# !n&&n##n i'*!% '!-"i*6 d!nn !+!i#n
#n*ii%!*i- "!!'+ *%#n""i$
4. M!n%n-#n #*# +!n)!( (!+"id!%"i" d!nn !+!%i#n #%!n*!%#' #* !n&(!'#"i
!"i 8iro chelating drugs:6 d! !%-"#+in di!%i-#n "-*#n d#'#+ #n&-# @/12 #+
d!nn +!n&&n#-#n +# %*#!' -!)i' 8"!'#+#* *id%:6 5/> +#'#+J+in&&$
5. S'!n-*+i #-(i%n,# di!%'-#n -#%!n# -%#n %n *!%"!* #*# -#%!n#
(i!%"'!ni"+! "!-nd!%$
6. #n&-- "+"+ *'#n& 8)"*: #d#'#( -%#*i #d# !nd!%i*# in% d#n *!'#( *!%-*i
-!!%(#"i'#n ,#n& +!nin&-#*$
B. P!n#*#'#-"#n##n P!%#4#*#n
1. P!%#4#*#n ++ . +#-#n#n d!nn &ii "!i+#n&
2. P!%#4#*#n -("" .
a. T%#n""i d#%#( di!%i-#n i'# -#d#% H %!nd#( "!-#'i 8-%#n& d#%i > &%;: #*# #n#-
*!%'i(#* '!+#( d#n *id#- #d# n#" +#-#n$b. S'!n!-*+i$ Di'#--#n #d# #n#- ,#n& !%+% '!i( d#%i 2 *#(n d#n i'# 'i+#
*!%'#' !"#% "!(in& %i"i- *!%#din,# *%#+# ,#n& !%#-i#* !%d#%#(#n )-
!"#%$
c. P!+!%i#n R%#n*i#6 (ind#%i %!#%#* ,#n& +!nndn& #* !"i$
d. P!+!%i#n D!"!%i#+in n*- +!n&(#+#* %"!" (!+"id!%"i" ,#i* +!+#n*
!-"-%!"i F!$ Un*- +!n&%#n&i #"%"i F! +!'#'i "" di#n%-#n +in+ *!($
e. T%#n"'#n*#"i "+"+ *'#n& 8n! +#%%4: n*- #n#- ,#n& "d#( !%+% di#*#"
1> *#(n$ Di Indn!"i#6 (#' ini +#"i( "'i* di'#-"#n#-#n -#%!n# i#,#n,# "#n* +#(#'
d#n "#%#n#n,# !'+ +!+#d#i$
C. P!n#*#'#-"#n##n P!n&#*#n
1. P!nd!%i*# *(#'#""!+i# #-#n +!n'#+i #n!+i# "!(in& "!'#' +!+*(-#n *%#n""i
d#%#( "!+% (idn,#$ Ci-# *id#-6 +#-# #-#n *!%#di -+!n"#"i *( n*-
+!+!n*- "!' d#%#( +!%#($ O%n *( !-!%# '!i( -!%#" "!(in& *!%#di'#(
!+!"#%#n #n*n&6 !+!"#%#n 'i+#6 !+!"#%#n (#*i6 !nii"i#n *'#n&/*'#n&
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#n#n&6 ,#n& #-i%n,# d##* +!n-i#-#n ' #n*n&6 !%* +!+n)i*6 d#n !n*-
*'#n& 4##( !%#( d#n "!%in& di"!%*#i #*#( *'#n& di"!%*#i *%#+# %inn$
2. A-i#* *%#n""i ,#n& !%'#n& +!n-i#*-#n !n+-#n !"i #d# %n/%n
*($ Y#n& *!%'i(#* d#%i '#% -'i* +!n#di -!(i*#+#n 6 "!+!n*#%# !n+-#n !"i di
d#'#+ *( ++n,# *!%#di #d# #n*n&6 -!'!n#% !nd-%in6 "!(in& d##*
+!-i#*-#n ' #n*n&6 !%*#" *!%'#+#*6 *id#- +!n"*%#"i6 !%*+(#n !nd!-6
#(-#n *id#- d##* +!+n,#i -!*%n#n$
3. A-i#* *%#n""i ,#n& !%'#n&6 -!+n&-in#n *!%*'#% !n,#-i* (!#*i*i" =6 (!#*i*i" 6
d#n HIV )!nd!%n& !"#%$ Ini ,#n& *!%-#d#n& +!+#* #n#- *(#'#""!+i# +!n#di %!nd#(
di%i$
4. K#%!n# *(#'#""!+i# +!%#-#n !n,#-i* &!n!*i-6 +#-# i-# d# %#n& !+#4# "i#*
*(#'#""!+i# +!ni-#(6 +!%!-# +!+n,#i -!+n&-in#n 25; #n#- n%+#'J "!(#*6 50;
#n#- !+#4# "i#*J *(#'#""!+i# +in%6 d#n 25; #n#- "#-i* *(#'#""!+i# +#,%$
D. P!n#*#'#-"#n##n P!n)!(#n$
a. P!n)!(#n %i+#%
P!n,'(#n "!!'+ !%-#4in#n 8+#%%i#&! )n"!''in&: n*- +!n)!(
!%-#4in#n di#n*#%# #"i!n T(#'#"!+i# #% *id#- +!nd##*-#n -!*%n#n ,#n&
(+i&*$ P!%-#4in#n #n*#%# 2 (!*#%i&* 8)#%%i!%: +!n&(#"i'-#n -!*%n#n . 25 ;
T(#'#"!+i# 8(+i&*:6 50 ; )#%%i!% 8(!*!%i&*: d#n 25 n%+#'$b. P!n)!(#n "!-nd!%
P!n)!(#n -!'#(i%#n #&i (+i&* d#%i #"#nn "#+i i"*%i d!nn
T(#'#"!+i# (!*!%i&* "#'#( "#* #'#n -!'#% #d#'#( in"!+in#"i #*#n d!nn
"!%+# !%#"#' d#%i dn% ,#n& !#" d#n T(#'#"!+i# *%i*$ K!'#(i%#n -#""
(+i&* *!%(ind#%i6 *!*#i 50 ; d#%i #n#- ,#n& '#(i% #d#'#( )#%%i!%6 "!d#n&-#n 50;
'#inn,# n%+#'$
Di#&n"i" %!n#*#' +!'#'i !+!%i-"##n DNA )#i%#n #+nin +!%#-#n "#*
-!+##n d#n di&n#-#n n*- +!ndi#&n"i" -#"" (+i&* in*%#/*!%in "!(in&
d##* di!%*i+#n&-#n *ind#-#n #%*" %-*" 8S!#%+#n d--6 199>:$
6. K($+l)a%)
A-i#* #n!+i# ,#n& !%#* d#n '#+#6 "!%in& *!%#di ' #n*n&$ T%#n""i d#%#(
,#n& !%'#n&/'#n& d#%i %"!" (!+'i"i" +!n,!#-#n -#d#% !"i d#'#+ d#%#( *in&&i6
"!(in& *!%*i+n d#'#+ !%#i #%inn *( "!!%*i (!#%6 'i+#6 -'i*6 #n*n& d#n
'#in/'#in$ H#' ini d##* +!n-i#*-#n n&&#n n&"i #'#* *!%"!* 8(!+-%+*"i":$
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Li+# ,#n& !"#% +d#( %*% #-i#* *%#+# ,#n& %inn6 -!+#*i#n *!%*#+# di"!#-#n
'!( in!-"i d#n ' #n*n&$
In!-"i "!%in& *!%#di d#n d##* !%'#n&"n& #*#' #d# +#"# #n#-/#n#-$ P#d# %#n&
d!4#"# +!n%nn,# ##' #% d#n &in#' d##* !%'#n&"n& %&%!"i -'!'i-i#"i" "!%in&
di+#i6 -+'i-#"i '#in .
• In#%- *'#n&
• N!-%"i"
• A"!*i) -#% !+%#'i"
• A"*!+i'i*i" 8*!%*#+# "#'+n!''#:
• H!+#*%i# "!%in& !%'#n&/'#n&
C. A%#&a! Ke+era/ata! Pe!*er)ta T&ala%%e$)a
1. Pe!"a')a!
=!!%## (#' ,#n& !%' di-#i d#n di!%(#*i-#n !%#4#* *!%(#d# !nd!%i*# T(#'#""!+i# ini6
,#i* .
1. A"#' K!*%n#n J K!4#%n!%##n
T(#'#"!+i# #n,#- di+#i #d# #n&"# di "!-i*#% '#* T!n( 8M!di*!%#ni#': "!!%*i
T%-i6 Yn#ni6 d''$ Di Indn!"i# "!ndi%i6 *(#'#"!+i# )- #n,#- di+#i #d# #n#-6
#(-#n +!%#-#n !n,#-i* d#%#( ,#n& #'in& #n,#- did!%i*#$
2. U+%
P#d# !nd!%i*# *(#'#"!+i# +#,% ,#n& &!#'# -'ini"n,# !'#"6 &!#'# *!'#( *!%'i(#*
"!#- #n#- !%+% -%#n& d#%i 1 *#(n6 "!d#n&-#n #d# *(#'#"!+i# +in% i#"#n,#
#n#- #-#n di#4# -! RS "!*!'#( "i# ? *#(n$
3. Ri4#,#* K!"!(#*#n An#-
An#- )!nd!%n& +d#( *!%-!n# in!-"i "#'%#n !%n##"#n #*#" #*# in!-"i '#inn,#$
Ini di-#%!n#-#n %!nd#(n,# H ,#n& !%n&"i "!#i #'#* *%#n"%*$
4. Ri4#,#* K!"!(#*#n K!'#%
T(#'#"!+i# +!%#-#n !n,#-i* -n&!ni*#'6 #di !%' di!%i-"# ##-#( %#n& *#
+!+n,#i &!n *(#'#"!+i#$ Ci-# i,#6 +#-# #n#- !%!"i- *!%-!n# *#'#"!+i#
+#,%$
5. Ri4#,#* I S##* H#+i' 8An*! n#*#' %! AN:
S!'#+# +#"# -!(#+i'#n6 (!nd#-n,# !%' di-#i "!)#%# +!nd#'#+ #d#n,# #-*%
%!"i- *#'#"!+i#$ A#i'# did #d# #-*% %!"i-6 +#-# i !%' di!%i*#(-#n
%!"i- ,#n& +n&-in "!%in& di#'#+i '!( #n#- "!*!'#( '#(i%$
6. P!%*+(#n d#n P!%-!+#nn
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S!i%n& did##*-#n d#*# #d#n,# -!)!nd!%nn n&&#n *!%(#d# *+#n& "!#-
+#"i( #,i$ T!%*#+# n*- *(#'#"!+i# +#,%6 !%*+(#n i"i- #n#-6 #d#'#( -!)i'
n*- +%n,# d#n #d#n,# -!*!%'#+#*#n d#'#+ -!+#*#nn "!-"#'6 "!!%*i *id#-
#d# !%*+(#n %#+* i" d#n -!*i#-6 -!)!%d#"#n #n#- +!n'#+i
!n%n#n$ N#+n #d# !ni" *(#'#"!+i# +in%6 "!%in& *!%'i(#* !%*+(#n d#n
!%-!+#nn #n#- n%+#'$
7. P'# M#-#n
T!%#di #n%!-"i# "!(in& #n#- "!%in& ""#( +#-#n6 "!(in& == %!nd#( d#n *id#-
"!"#i "i#$
8. P'# A-*ii*#"
An#- *!%'i(#* '!+#( d#n *id#- "!'in)#( #n#- "!"i#n,#$ An#- '!i( #n,#-
*id%Ji"*i%#(#* -#%!n# #n#- +d#( '!'#($
2. Pe$er)%aa! -)%)
D#*# K!#d##n Fi"i- #d# An#- T(#'#"!+i#6 ,#i* .
a. KU '!+#( d#n -%#n& !%i%#(6 *id#- "!'in)#( #n#- '#in ,#n& "!"i#$
b. K!#'# d#n !n*- +-#
An#- ,#n& !'+ +!nd##*-#n !n&#*#n +!+n,#i !n*- -(#"6 ,#i* -!#'#
+!+!"#% d#n +-# +n&'id 8(idn& !"!- *#n# #n&-#' (idn&:6 #%#- +#*#'!#%6 *'#n& d#(i *!%'i(#* '!#%$
c. M#*# d#n -nn&*i# )#* d#n -!-ninn
d. M'* d#n ii% *!%'i(#* -!(i*#+#n
e. D#d# . P#d# in"!-"i *!%'i(#* d#d# -i%i +!nn' -#%!n# #d#n,# !+!"#%#n #n*n&
d#n di"!#-#n '!( #n!+i# -%ni-$
f. P!%* . T!%'i(#* )#*6 di#'#"i #d# !+!"#%#n 'i+# d#n (#*i 8(!#*"!-
n+!'i:$
g. P!%*+(#n i"i-n,# '!i( -!)i' d#%i#d# n%+#' "!"#i "i#6 == di #4#( n%+#'
h. P!%*+(#n %n "!-" "!-nd!% n*- #n#- #d# "i# !%*#" *id#- *!%)##i
d!nn #i-$ Mi"#' *id#- *+( %#+* -!*i#-6 i" #*#n -+i" #(-#n
+n&-in #n#- *id#- d##* +!n)##i *## d'!n"! -#%!n# #d#n,# #n!+i# -%ni-$
i. K'i* . W#%n# -'i* )#* -!-ninn6 i-# #n#- *!'#( "!%in& +!nd##* *%#n""i 4#%n#
-'i* #-#n +!n#di -!'# "!!%*i !"i$ H#' ini *!%#di -#%!n# #d#n,# !n+-#n #*
!"i d#'#+ #%inn -'i* 8(!+"id!%"i":$
3. D)a"!(%a NANDA NO NI
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1. In*'!%#n"i #-*ii*#" !%(nn d!nn -!*id#-"!i+#nn #n*#%# "'#i O2 d#n
-!*(#n$
2. !%#(#n !%"i #%inn !%(nn d!nn !n%n#n -+n!n "!''!% ,#n&
di!%'-#n n*- !n&i%i+#n O2 -! "!'$
3. R!"i- in!-"i !%(nn d!nn !%*#(#n#n "!-nd!% *id#- #d!-#*6 !n%n#n
H6 '!-!ni# #*# !n%n#n &%#n'"i*$
NANDA NO NI
In*'!%#n"i #-*ii*#"
!%(nn d!nn
-!*id#-"!i+#nn
#n*#%# "'#i O2 d#n
-!*(#n$
T(lera!%) at))ta%
Klien diharapkan mampu
untuk menormalkan:
• S#*%#"i -"i&!n -!*i-#
!%#-*ii*#"
• D!n,* n#di -!*i-#
!%#-*ii*#"
• L# !%n##"#n -!*i-#
!%#-*ii*#"
• T!-#n#n d#%#( "i"*'i-
• T!-#n#n d#%#( di#"*'i)
• P!+!%i-"##n EKG
• W#%n# -'i*
• K!-#*#n *( #*#"
• K!-#*#n *( #4#(
Da,a ta&a!
Klien diharapkan mampu
untuk menormalkan:
• Kin!%# d#%i %*ini*#"
• A-*ii*#"
• Kn"!n*%#"i
• K!'i(#n !n!%&, "!*!'#(
!%#-*ii*#"
• Tin&-#* -"i&!n d#%#(
T)!"at e"el)%a&a!
Klien diharapkan mampu
untuk menormalkan:
• N,!%i
• !+#"
• M!n&!%#n&
• S*%!""
• T#-*
• K!&!'i"#(#n
• N,!%i **
• M!%in&i"
Tera+) at))ta%
Intervensi yang dilakukan:
• K'#%#"i d!nn *!%#i" d#'#+
+!%n)#n#-#n d#n +!+ni*%
%&%#+ #-*ii*#"
• M!nin&-#*-#n -+i*+!n #"i!n
d#'#+ !%#-*ii*#"
• M!+#n* +!n&!-'%#"i #-*ii*#"
,#n& !+#n##* #&i #"i!n
• M!+#n* +!n&id!n*ii-#"i
"+!%d#,# ,#n& di+i'i-i d#'#+
!%#-*ii*#"
• M!+#n* #"i!nJ-!'#% d#'#+
!%#d#*#"i d!nn 'in&-nn
• M!+#n* +!n,"n #-*ii*#" i"i-
• P#"*i-#n 'in&-nn #+#n n*- !%&!%#-#n **
• C!'#"-#n #-*ii*#" +*%i- n*-
+!nin&-#*-#n *n" **
• =!%i-#n %!in%)!+!n "i*i "!'#+#
!%#-*ii*#"
• Mni*% %!"n !+"in#'6 i"i-6
""i#' d#n "i%i*#'
Ma!a'e$e! e!er",
Intervensi yang dilakukan• T!n*-#n !+#*#"#n #-*ii*#" i"i-
#"i!n
• C!'#"-#n *#nd# ,#n& +!n,!#-#n
-!'!+#(#n
• C!'#"-#n !n,!# -!'!+#(#n
• C!'#"-#n ## d#n #i+#n#
#-*ii*#" ,#n& di*(-#n n*-
+!+#n&n !n!%&i
• Mni*% in*#-! n*%i"i ,#n& #d!-#*
• Mni*% %!"n -#%di%!"i%#"i
"!'#+# #-*ii*#"
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• S!"#- n##"
• M#'
• Mn*#(
• Mni*% '# *id%
• Mni*% '-#"i
-!*id#-n,#+#n#nJn,!%i
• =#*#"i "*i+'" 'in&-nn
• An%-#n !d%!"*
• L#--#n ROM #-*iJ#"i • =#n* #"i!n +!+#* #d4#'
i"*i%#(#*
• Mni*% !!- #* "*i+'#n d#n
d!%!"#n
• Mni*% %!"n -"i&!n#"i #"i!n
P!%#(#n !%"i
#%inn !%(nn
d!nn !n%n#n
-+n!n "!''!% ,#n&
di!%'-#n n*-
!n&i%i+#n O2 -! "!'$
1. P!%"i #%inn .
!%i!%
K%i*!%i# ,#n& di(#"i'-#n .• TTV
• O** %in!
• K!"!i+#nn
!'!-*%'i* #"#+ #"#
• K!"!i+#nn )#i%#n
• =i"in& ""
• N#" +#-#n
• K!(#"#n ,#n&
#n%+#'
•
N,!%i !%* ,#n&#n%+#'
• M#' *id#- di*!+-#n
• Mn*#( *id#-
di*!+-#n
• D!i"i!n"i +#'
#"%"i
• Di"*!n"i #d+in#'
*id#- di*!+-#n
• A"i*!" *id#-
di*!+-#n
• Kn"*i#"i *id#- di*!+-#n
• Di#%! *id#-
di*!+-#n
• K!#*#n "!"ii-
di#%!
• =UN D=N
• K%!#*in! '#"+#
D=N
• Fn&"i (#*i *!"* D=N
•
Eni+ P#n-%!#" D=N
PERAWATAN SIRKULASI
De-e!)%) Tin&-#*-#n "i%-'#"i #%*!%i d#n
!n#
At))ta%
• L#--#n !ni'#i#n d#%i "i%-'#"i
-!"!'%(#n 8! . !%i-"# d!*#-
-!"!'%(#n6 !d!+#6 -#i'!% %!i'6
4#%n#6 d#n "( d#%i !-"*%!+i*#":
• E#'#"i !d!+# d#n d!n,*#n
-!"!'%(#n
• P!%i-"# -'i* n*- "*#"i" '"!%#"i
#*# '-#
• P#'#"i #n&&*# #d#n d!nn *!'i*i• K#i d!%##* -!*id#-n,#+#n#n d#n
n,!%i
• R!nd#(-#n !-"*%!+i*#" n*-
+!nin&-#*-#n "i%-'#"i #%*!%i6 i-#
+!+n&-in-#n
• Gn#-#n "*-in& #n*i!+'i"+! 8!
. !'#"*i" #*# "*-in& ,#n& !%i"i
d#%#:6 i-# +!+n&-in-#n
• =-# "*-in& #n*i!+'i"+! "!'#+#
15/20 +!ni* "!*i# @ (#%i
• An&-#* #d#n 200 #*# '!i( di#*#"
#n*n& n*- +!nin&-#*-#n !n"
%!*%n6 i-# +!+n&-in-#n
• =!%i-#n !n&#*#n #n*i'#*!'!* #*#
#n*i-#&'#n6 i-# +!+n&-in-#n
• U#( "i"i #"i!n #'in& "!di-i*
"!*i# 2 (#%i6 i-# +!+n&-in-#n
• Gn#-#n *!+#* *id%J+#*%#"
*!%#!*i-6 i-# +!+n&-in-#n
• An%-#n '#*i(#n ROM #"i #*#
#-*i "!'#+# i"*i%#(#*6 i-#
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2. In*!&%i*#" #%inn .
+!+%#n! -'i* d#n
+-"#
K%i*!%i# ,#n& di(#"i'-#n .
• S( C#%inn• S!n"#"i
• E'#"*i"i*#"
• Hid%#"i
• Pi&+!n*#"i
• R!"i%#"i
• W#%n#
• T!-"*%
• K!*!#'#n
• C#%inn ,#n& *#- '-#
•C#%inn P!%"i
• P!%*+(#n %#+* di
-'i*
• K!'!n&-##n -'i*
+!+n&-in-#n
• An%-#n #"i!n #(4# !n*in&n,#
+!n)!( !n# "*#"i" 8! . *id#-
+!n,i'#n&-#n -#-i6 +!nn&-#*
-#-i *#n# +!'i#* '**6 d#n
'#*i(#n:• A#%-#n #"i!n n*- !%#4#*#n
-#-i ,#n& *!#*
• P!'i(#%#J#*% (id%#"i ,#n& #d!-#*
n*- +!n)!( !nin&-#*#n
-!-!n*#'#n d#%#(
• Mni*% "*#*" )#i%#n6 !+#"-#n
in*#-! d#n **
Ma!a'e$e! Se!%a%) Per)-er
A-*ii*#" .
• P#n*# -!*##+#nJ -!*+'#n #*# #n#" J din&in #&i#n !%i!% #"i!n
8 -'i* :
• P#n*# #d#n,# P#%#"*(!"i# . -!#" 6
-!"!+*#n 6 (i!%#%#"*(!"i# d#n
(i#%#"*(!"i#
• D%n& #"i!n n*- +!n&&n#-#n
#&i#n *( ,#n& +#"i( "!(#*
n*- +!n&id!n*ii-#"i J
+!n!n*-#n "( d#%i +#-#n#n 6
+in+#n 6 #i% n*- +#ndi 6 d''• D%n& #"i!n n*- +!n&&n-#n
#&i#n *( ,#n& "!(#* n*-
+!n&id!n*ii-#"i J +!n!n*-#n
'-#"i #*# *!-"*%! "#* !nd#
• In"*%-"i-#n -!#d# #"i!n J
-!'#%n,# n*- +!+!%(#*i-#n
"i"i #&i#n #&i#n *( -!*i-#
+#ndi 6 dd- 6 #*# !%ind#( J
+!%#( "i"i *(n,#
• In"*%-"i-#n -!d# #"i!n J -!'#%
n*- "!'#' +!+!%i-"# J +!+#n*#in*!&%i*#" -'i* ,#n& +!n'#+i
)!d!%# J n&&#n "!n"#"i "!*i#
(#%i
• Mi!%*+i* d#- ni*%J #n*#
-!+#+#n #"i!n n*-
!%#-#i#n J+!+#-#i # 6 "!#* 6
#'#* #n* #"i!n -#'# #d# 6 d''
• In"*%-"i-#n -!#d# #"i!n J
-!'#% n*- +!n&&n#-#n
*(!%++!*!% n*- +!n&!)!- "(
#i% • Gn#-#n %in"i "*!%i' -!*i-#
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+!+!%"i(-#n !%#'#*#n +#-#n
#"i!n
• Gn#-#n "#%n& *#nn #*#
#-#i#n !'indn& '#inn,# #d#
*(-!*i-# *( !%-n*#- d!nn
!- ,#n& !%*!n"i +!nndn&#* #* !%#(#,# 8 +i"#'n,# .
-#%!n# "( 6 *!-"*%!6 #*#
-#%#-*!%i"*i- '#in,#:
• Hind#%i #*# (#*i (#*i d'#+
!n&&n###n #%#n& #%#n& ,#n&
+!+i'i-i "( *!%*!n* 6 "!!%*i
(!#*in& #d6 *!%+" 6 d#n i)! #)-"
• An%-#n d#n ##%i #"i!n )#%#
!%#'#n ,#n& #i- 6 &n#-#n "!#*
,#n& '!+* d#n *id#- !%*+i* #*#
*+i*n,# %!nd#(
• L!*#--#n #*# #"#n& )%#d'! di #*#"
#&i#n *( ,#n& +!n'#+i
n&&#n n*- +!n)!(
*!%"in&&n& '!( #&i#n *!+#*
*id% ,#n& '#in
• !- #*# !%i-"# #d#n,# !nd#
!nd# #"in& di "!#* 6 -#n*n& #
d#n #-#in #"i!n
• In"*%-"i-#n -!#d# #"i!n n*-
+!n&#(/ #( ""i"in,# 8 "!"#id!nn 4#-* 4#-* *!%*!n*:
-!*i-# #d#n,# %#"# *id#- n,#+#n
• K%#n&i !n&&n##n #'#* #'#*
,#n& d##* +!ni+'-#n *!-#n#n
#d# #"i!n "!)#%# *!#* d#n "!"#i
d!nn ndi"i #"i!n
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19
8/17/2019 THALASSEMIA klp 2.rtf
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*%+('!i*i" #*# *(%+"i"
d#%i !+'( !n#
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20
8/17/2019 THALASSEMIA klp 2.rtf
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#"#+6 i-# di!%'-#n
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di!%'-#n
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21
8/17/2019 THALASSEMIA klp 2.rtf
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• M!n!'#"-#n *#nd# d#n
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,#n& diindi-#"i-#n d#n di&n#-#n
n*- *ind#-#n in#"i!6 !%#"i d#n
#* d#%%#*
MANA4EMENT LIN4KUN4AN
AKTIVITAS• C#(i "!n#*# ,#n& *!n"i#' d#%i
'in&-nn -'i!n 8 !nd# *##+ 6
!%#* 6 d#n '#in '#in:
• M!n)#%i 'in&-nn "!)#%# %*in
n*- +!+!'i(#%# -'i!n !#" d#%i
#(#,#
• M!n)#%i #"i!n ,#n& +!+n,#i
"!n#*# "!'#+# +#"# !%#4#*#n 6
"!)#%# *!#*
• P#n*# -!#+#n#n #'#* #'#* ,#n&
di#4# !n&nn& -! "!-i*#% -'i!n• In"*%-"i-#n !n&nn& d#n !*"
22
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-!"!(#*#n ,#n& '#in +!n&!n#i
in%+#"i -!#+#n#n -'i!n
• =#*#"i -'i!n +!n&&n#-#n "!n#*#
,#n& *!n"i#' 8 "!!%*i "!n#*# *##+ 6
!%#* 6 d'':
• P#n*# #"i!n "!'#+# +!n&&n#-#n"!n#*# *!n"i#' 8 "!!%*i . i"#
)-%:
• T!+#*-#n #"i!n -!#d# *!+#*
,#n& n,#+#n #&i -'i!n d!nn
#%+# *!%#i n*- +!n%n-#n
!n"inn d#n -!"!+#*#n n*-
+!'-#i 6 "!)#%# *!#*
• =!%i-#n %#nn "!ndi%i n*- #"i!n
+!n&(ind#%i -!"!+#*#n #d#n,#
!%i'#- -!-!%#"#n -!#d# %#n& '#in
• T!+#*-#n %#nn #"i!n did!-#*
%#n& !%#4#*
• =#*#"i #-"!" #"i!n -! !nd!'#
6-!)#'i i'# -n)i d#n !nd#'# *#(#n
!)#( 6"!)#%# *!#*
• Kn)i -!!%'#n d#n &d#n&
• S!di#-#n !%'!n&-##n +#-#n d#%i
'#"*i)
• T!+#*-#n #"i!n #d# 'in&-nn
,#n& di#*#"i "!(in& *!%(ind#% d#%i
-!+n&-in#n ,#n& #d#• S!di#-#n !n#" #d# #-"!" #%!#
n*- +!+!'i(#%# -!#+#n#n #"i!n
d#n in*!n"i *!%#!*i- 6 -#'#
di!%'-#n
• C#(i indiid d#%i "!-i*#% *!%#din,#
-!-!%#"#n J -!-!%#"#n *!n"i#' #d#
-'i!n
• M!+!'i(#%# !n*- d#!%#( ,#n&
#+#n 8 -#+#% !n"inn : -!#d#
#"i!n -!*i-# i# +!n+-
• T!%#-#n "#%n& 6 *#nn 6 !'#*6
(!'+6 #*# !n#(#n n*- +!+#*#"i
d#n -!+#+#n n*- +!+'#i
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"!)#%# *!#*
• S!di#-#n '#"*i) 6 "!+i !"i 6 #
n*i 6 "!)#%# *!#*
23
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BAB III
PENUTUP
A. Ke%)$+#la!
T(#'#"!+i# . !n,#-i* #4##n ,#n& di*%n-#n '!( "#'#( "#* %#n&*# -!#d#
#n#-n,# "!#- +#"i( d#'#+ -#ndnn$ Ci-# #"#nn "#+i/i"*%i #d#'#( !+#4# &!n
*(#'#"!+i#6 +#-# -!+n&-in#n #n#-n,# #-#n +!nd!%i*# *(#'#"!+i# "!!"#% 25;6 !+#4#
&!n *(#'#""!+i# 850;: d#n n%+#' 825;:
K#+i +!n+i' 3 "!#i di#&n"! n*- !nd!%i*# *(#'#""!+i# .
1. In*'!%#n"i #-*ii*#" !%(nn d!nn -!*id#-"!i+#nn #n*#%# "'#i O2 d#n
-!*(#n$
2. !%#(#n !%"i #%inn !%(nn d!nn !n%n#n -+n!n "!''!% ,#n&
di!%'-#n n*- !n&i%i+#n O2 -! "!'$
3. R!"i- in!-"i !%(nn d!nn !%*#(#n#n "!-nd!% *id#- #d!-#*6 !n%n#n
H6 '!-!ni# #*# !n%n#n &%#n'"i*$
B. Sara!
D!nn #d#n,# +#-#'#( ini -#+i !%(#%# d##* +!+#n* +!n#+#( 4#4#"#n
!+#)# d#n d##* +!n'i-#"i-#n #"(#n -!!%#4#*#n ,#n& *!'#( di##%-#n$
24
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DAFTAR PUSTAKA
='!)(!)-6G'%i# d--$ 200@$N%"in& In*!%!n*in" '#""ii)#*in 8NI:6Fi*( Edi*in$Uni*!d
S*#*! . M",
D%'#nd$199@$K#+" S#- K!d-*!%#n$ C#-#%*# . EG
G,*n6 A%*(% 6 82000:6 =- Ajar Fisiologi Kedokteran, edisi 6 EG6 C#-#%*#$
H!%d+#n6 T$ H!#*(!%$ 2009$ !anda International, !ursing "iagnosis: "effintion #
Classification $%%&$%''( Sin%!. M#%-n P%in* M!di# P*! L*d
M%(!#d6 S! d--$ 200@$N%"in& O*)+!" '#""ii)#*in 8NO:6F%*( Edi*in$Uni*!d
S*#*!.M",
S%i#di6 Ri*# Y'i#ni6 82001:6 Asuhan Kepera)atan Pada Anak, edisi I, C* $ S#&n& S'6
C#-#%*#$